ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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Right to Abort in Surrogacy Contracts

This article makes an enquiry into the right to abort in surrogacy contracts as visualised by the bill on Assisted Reproductive Technology drafted by the Indian Council of Medical Research and introduced in Parliament in 2010. It argues that the bill's anti-abortion clause raises important questions of ethics, fundamental rights as well as legal remedies, if any, in the event of a breach of contract.

Outsourcing Reproduction

Sourcing Surrogates: Actors, Agencies and Networks by V Deepa, Mohan Rao, Rama Baru, Ramila Bisht, N Sarojini and Susan Fairly Murray (New Delhi: Zubaan Publishing Services), 2013; pp 98, price not mentioned.

Responding to Sexual Violence

This paper is based on the results of establishing a comprehensive health-sector response to sexual violence. Eliminating existing forensic biases to rape and the neglect of healthcare needs of survivors, the model uses gender-sensitive protocol for medico-legal documentation of sexual violence, which focuses on informed consent, documentation of the nature of sexual violence, and collection of relevant forensic evidence. It uses standard treatment guidelines for the provision of treatment, and ensures psychosocial support to the survivor. The results indicate that a sensitive response by health professionals can play a crucial role in healing from sexual abuse.

Nutrition: What Needs To Be Done?

About 805 million people - one in nine people worldwide - remain chronically hungry. Ending hunger and malnutrition requires strong political commitment at the highest level, effective coordination among various ministries and partners, and broad-based social participation. Three policy priorities are crucial to ending malnutrition - expansion of social protection; making smallholder agriculture more nutrition sensitive; and focusing on under-fi ve child and maternal nutrition defi ciencies. An integrated approach is needed to ensure that food consumed is nutritious, wholesome, acceptable, safe and affordable, especially to the poorest and most vulnerable.

Death of a Dai

In the case of childbirth, obstetrics is equated with development-modernity, while dais symbolise the lacking space which needs to be either co-opted through training or obliterated. The state, in its approval of this modernising project, offers several incentives and disincentives, even as everyday practice and the choices women make on the ground indicate a far complex reality. By moving through the life story of a real dai, this article underscores the absurdities and ironies that waylay the grand project of development-modernity in its journey towards its goal.

Testing Chastity, Evidencing Rape

Through a detailed analysis of the history of medical jurisprudence textbooks and their use in case law, this paper argues that these textbooks undermine legal reforms in India. It establishes that medical manuals promote the collection of prejudicial and legally irrelevant evidence and reinforce the notion that Indian women frequently bring false charges of rape. Courts regularly cite these textbooks as authority in rape cases, based on the perceived objectivity of medical science as a form of evidence. For legal reforms to be effective, this article argues that changes must be made to textbooks of medical jurisprudence, medical syllabi, and to protocols of medical examination and assessment of rape victims. Further, courts must be more critical in their use and acceptance of these medical manuals.

Dangerous Motherhood

Despite recent improvements in the maternal health scenario in rural Assam, it remains the state with the highest number of maternal deaths in the country. Institutional delivery, antenatal care, and postnatal care have been actively promoted by the state to deal with the situation. However, state policies are still incongruously geared towards addressing the issue without taking sufficient note of the various sociocultural impediments in the way of institutional care.

Engendered Access or Engendered Care?

A central feature of many developing countries is the presence of significant gender differentials in health outcomes. Two potential factors that can account for this are that females access treatment later than males and that they receive differential care at the medical facility. This paper explores both of these in the context of eye care. The paper studies diagnostic and surgical outcomes of 60,000 patients who sought treatment over a three-month period in 2012 at the Aravind Eye Hospital in Madurai, Tamil Nadu. The results show that at presentation, women have worse diagnoses than men for indicators of symptomatic illness. To resolve gender-based health inequalities in developing countries, we need to know where these inequalities lie. This paper finds them in access but not care. The findings suggest that women seek treatment later than men for symptomatic illness. That no such gender differential exists for asymptomatic diseases suggests that women do not necessarily go for regular preventive check-ups at a lower frequency than men. The paper finds no systematic evidence that women and men receive differential medical treatment.

A Matter of Life and Death

India's maternal mortality rate has declined, but much more needs to be done.

Demand-side Financing and Promotion of Maternal Health

Use of demand-side financing has become increasingly common in maternal healthcare and India has been a leading example with large-scale programmes such as the Janani Suraksha Yojana and Indira Gandhi Matritva Sahyog Yojana. This paper undertakes a systematic review of the evidence to consider how demand-side financing has been used and whether there has been any impact on maternal health service utilisation, maternal health, or other outcomes. The findings suggest that a relatively narrow focus on achieving targets has often overburdened health facilities, while inadequate referral systems and unethical practices present overwhelming barriers for women with obstetric complications. The limited evidence available also suggests that little has been done to challenge the low status of poor women at home and in the health system.

Recency of Birth as Marker of Future Fertility

The persistence of high growth rates of the population in a number of states is calling to question the wisdom and feasibility of integrating family planning programmes in a larger reproductive health package as recommended in the National Population Policy 2000. There is an apparent inconsistency between the needs of the state governments to regulate population growth and fertility levels as part of developmental strategies and the requirements for implementation of family planning programmes as a part of a larger reproductive health package. In this article an attempt is made to reconcile this inconsistency through a birth-based approach to contraception which is feasible, humane and effective in terms of its fertility impact. The data from NFHS-2 are used to empirically validate the approach.

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